The nurse is assessing a client suspected of having renal calculi who reports severe, wavelike pain that radiates down the thigh and to the genital area and a sensation of needing to void, but only small amounts are voided.
The nurse should explain which of the following information to the client?
"Stones that are lodged in the ureter cause symptoms like you are describing.”.
"You will most likely pass the stones in the next few hours.”.
"Your symptoms are consistent with stones that are lodged in the bladder.”.
"The stones will need to be removed through a procedure.”. .
The Correct Answer is A
Choice A rationale
Ureteral stones cause severe, colicky pain that radiates to the groin or genital area. The ureter’s narrow anatomy can trap stones, causing obstruction. This obstruction triggers increased intrarenal pressure and ureteral spasms, producing waves of intense pain. Hematuria and urinary urgency with minimal voiding are common due to mucosal irritation or obstruction.
Choice B rationale
While small stones may pass spontaneously, predicting exact timelines is speculative. Passage depends on factors like stone size, location, and hydration. For stones larger than 5 mm, spontaneous passage rates decrease, often requiring intervention. Therefore, giving definite timeframes may misinform patients and delay appropriate care.
Choice C rationale
Bladder stones typically cause suprapubic pain, urinary frequency, and hematuria rather than radiating pain to the thigh or genital area. Bladder irritation may lead to dysuria or cloudy urine, but the described symptoms are more consistent with ureteral obstruction rather than bladder involvement.
Choice D rationale
Some stones do require procedural removal, especially those causing recurrent infections or obstruction. However, initial management includes conservative measures like hydration and pain control, reserving procedures for unresolvable cases. Early procedural focus may unnecessarily alarm the client or overlook noninvasive options.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Serum electrolyte analysis provides insights into fluid and electrolyte balance but does not specifically diagnose heart failure. Electrolyte changes may occur secondary to heart failure but are not definitive markers for the condition.
Choice B rationale
Complete blood count evaluates for anemia or infection, which may contribute to symptomatology but is not diagnostic for heart failure. Heart failure diagnosis focuses on cardiac-specific markers rather than hematologic parameters.
Choice C rationale
Blood urea nitrogen assesses renal function and reflects perfusion status but lacks specificity for heart failure. Although renal dysfunction may occur in advanced heart failure, BNP measurement is more definitive for cardiac assessment.
Choice D rationale
Brain natriuretic peptide (BNP) is a key diagnostic marker for heart failure. Elevated BNP levels occur due to ventricular stretch and strain associated with fluid overload, a hallmark of heart failure. Normal BNP levels are typically <100 pg/mL, with elevated levels strongly suggesting cardiac dysfunction. .
Correct Answer is B
Explanation
Choice A rationale
Magnesium and bilateral lower extremity ultrasounds are not primary diagnostic tests for hypertension-related target organ damage. Magnesium levels do not directly correlate with hypertension complications, and lower extremity ultrasounds mainly evaluate vascular issues, such as deep vein thrombosis, rather than organs affected by chronic hypertension.
Choice B rationale
Urinalysis assesses kidney function by detecting proteinuria, an indicator of renal damage due to hypertension. Blood chemistry provides electrolytes and renal function metrics, like creatinine (normal range: 0.6–1.2 mg/dL). A 12-lead ECG identifies left ventricular hypertrophy or arrhythmias linked to cardiac strain from persistent high blood pressure, a common sign of target organ damage.
Choice C rationale
Complete blood count evaluates overall health but does not specifically target organ damage related to hypertension. Electroencephalogram measures brain activity and is more relevant for neurological conditions, such as seizures, not complications from high blood pressure.
Choice D rationale
Troponin evaluates myocardial injury in acute settings like myocardial infarction, unrelated to chronic hypertension-induced organ damage. Calcium levels and partial thromboplastin time assess coagulation and bone health but do not directly indicate target organ involvement in hypertension.
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